Despite differing criteria used to determine the functional progression of glaucoma, retinal nerve fiber layer loss measured using optical coherence tomography occurred at a significantly higher rate in eyes with standard automated perimetry progression vs. eyes without progression, according to a study.
The study included 46 eyes of 23 patients with perimetric glaucoma prospectively enrolled in the Advanced Imaging in Glaucoma Study; a control group consisted of 30 eyes of 15 age-matched healthy patients. All study participants had at least 3 years of follow-up.
Inclusion criteria were spherical equivalent refractive error between –7 D and +3 D, best corrected visual acuity of at least 20/40, age range between 40 and 85 years, reliable standard automated perimetry, and no prior history of intraocular surgery other than uncomplicated cataract extraction.
All study participants underwent OCT and standard automated perimetry imaging to evaluate retinal nerve fiber layer (RNFL) loss. Standard automated perimetry progression was defined using four analysis methods.
The rate of RNFL loss was significantly greater in progressing eyes compared to nonprogressing eyes (P < .05). The rate of loss seen in nonprogressing eyes was similar to the rate found for age-matched healthy control eyes (P < .05).
OCT imaging was useful for detecting glaucomatous structural progression, as well as determining the rate of progressive retinal nerve fiber loss, the authors said.
“The current findings provide additional support for the use of longitudinal [RNFL thickness] measurements as an endpoint in clinical trials for detection of progressive glaucomatous structural atrophy,” the authors said.